U.S. H1N1 vaccine campaign challenging, speakers say

WASHINGTON — First, people were clamoring for H1N1 vaccines, but there were not enough to go around. By the time vaccines were available in any quantity, most of the public had lost interest.

And no one knew just how unpredictable the production of vaccines would turn out to be, top U.S. public health leaders agreed March 5.

Getting people to get vaccinated was definitely one of the biggest challenges to managing the pandemic of H1N1 flu, speaker after speaker agreed at a conference on influenza regrets covered by Reuters.

"The truth is for this pandemic we had about the longest warning we might ever have for a potential biothreat," said Dr. Nicole Lurie, who heads preparedness at the U.S. Department of Health and Human Services.

"And yet we all lament how long it took for vaccine to be made," she told the conference, sponsored by the Center for Biosecurity at the University of Pittsburgh Medical School.

The U.S. Centers for Disease Control and Prevention estimates H1N1 has killed about 12,000 Americans, and possibly as many as 17,000. It put 250,000 into the hospital.

When the flu outbreak was first detected in April, officials got flu manufacturers working on a vaccine within weeks, and the CDC said more than half the U.S. population should be vaccinated quickly.

Health and Human Services Secretary Kathleen Sebelius said 250 million vaccines had been ordered and any American who wanted to be vaccinated would be able to get a flu shot.

"We told people to prepare to be vaccinated in October and then we didn't show up with vaccine," said David Lakey, Texas’ state health commissioner.

First, vaccine makers had trouble growing the virus. Then there were problems getting vaccines into vials and shipped. And, experts told the meeting, other problems popped up.

"The most vaccine we ever shipped in one week was 16 million doses," the CDC's Anne Schuchat told the meeting. Initial predictions had been for 20 million a week.

"All the vaccine in the world is not going to work if you can't deliver it," CDC Director Dr. Thomas Frieden said.

Maryland's Health Secretary John Colmers bemoaned initial predictions about vaccine supply.

"It had a profound effect on our ability to plan," he said. "Supply didn't equal demand. We had a lot of demand, not a lot of vaccine, and then we had a lot of vaccine and not much demand."

Further complicating things -- the United States uses five suppliers, each of whom made vaccine in a slightly different way. The CDC and HHS had to patch together a network of manufacturers, a distributor and numerous retail clinics, hospitals, doctor's offices, employers, state and city health departments.

Then Americans were on their own to decide if and when to get vaccinated.

"Our colleagues in the U.K. said no problem — we just tapped into the electronic health records," Frieden said. They were able to identify patients with high-risk conditions and invite them to come in and be vaccinated by appointment.